Assessment of Neurological Impact of HIV-2 in West Africa This project is designed to develop capacity for clinical neurological assessment of human immunodeficiency virus induced neurological complications in West Africa, enhancing and sharing expertise of investigators at Washington University in St. Louis and other US centers with the Medical Research Council Laboratories in The Gambia and the Universite Cheikh Anta Diop of Dakar (Senegal). The project will develop clinical tools for description of neurological function relevant to HIV-1 and HIV-2 infection and train teams at African sites to reliably apply the tool to established cohorts of HIV-2 patients and controls. The project will characterize the prevalence and characteristics of neurocognitive impairment, peripheral neuropathy and myelopathy in HIV-2 subjects. Through the project the capacity to perform neurological assessments will be enhanced and teams will be established for future investigations. The project will also establish data sharing procedures for multicenter neuroclinical trials in West Africa. Pilot observations of neuroimaging and CSF characteristics of HIV-2 infected subjects, observations relevant to aging with HIV-2 infection, and description of the neurological opportunistic infections associated with HIV-2 will be provided to enhance future research projects. The project is designed to develop the capacity to undertake more detailed and mechanistic studies of neurological manifestations of HIV in West Africa in subsequent research applications. PUBLIC HEALTH RELEVANCE: Neurological impact of HIV infection is extremely common and is seriously disabling. HIV-2 is likely to also have significant neurological complications, yet has not been systematically studied. HIV-2 is prevalent in West Africa, and thus uniquely problematic for this region. Local expertise to study neurological complications is presently lacking, making this grant timely in providing an opportunity to develop the capacity to probe this complication by developing expertise for application in already established cohort studies. The project is responsive to needs of the communities suffering with HIV and is responsive to the program announcement seeking capacity building international projects.